Surgical instrument



May 23, 1967 E. soKoLlK 3,320,957

SURGICAL INSTRUMENT Filed May 2l, 1964 5 Sheets-Sheet l E. SOKOLIK May 23, 1967 SURG I CAL INSTRUMENT 5 SheetsSheet 2 Filed May 2l, 1964 K J m @uw R m WD 4 E. SOKOLIK May 23, 1967 SURGICAL INSTRUMENT Filed May 2l, 1964 5 Sheets-Sheet 4 mvENToR. Inu/.4kb .S'o/u/K BY MM,

rram/zrs May 23, 1967 E. soKoLlK SURGICAL INSTRUMENT 5 Sheets-Sheet 5 Filed May 2l, 1964 m w MHNHNJM M United States Patent O 3,320,957 SURGICAL INSTRUMENT Edward Sokolik, 5601 Dupont Ave. N., Minneapolis, Minn. S5430 Fired May zr, 1964, ser. No. 369,141 23 Claims. (Cl. 12S- 311) This invention relates generally to surgical instruments and is more particularly directed to transurethral resectng apparatus and equipment and apparatus for use in performing prostatic surgical operations.

In the prior art with which my invention is concerned, various types of instruments for the transurethral resecting of tissue in the surgical procedure followed in a prostatectomy have been utilized. However, as will be set forth below, my discovery provides an improved performance and results not attained with prior art apparatus.

Among the features of my invention Iare a radially expandable resectng, or cutting, mechanism which provides a shearing action for the removal of tissue, a means and apparatus for accurately positioning the cutting mechanism at the proper location for performing the surgical procedure and a further means for rapidly conveying removed tissue away from the region in which the surgical procedure is undertaken.

It is therefore an object of my invention to provide an improved transurethral resectng instrument for performing surgical operations.

Another object of my invention is to provide improved surgical apparatus for performing transurethral surgical procedures which may be accurately positioned in the region at which the surgical procedure is to be undertaken.

A still further object of my invention is to provide an improved surgical instrument for performing transurethral prostatic surgery which is easier to operate, operates in a faster and more efficient manner, provides improved accuracy in the surgical resectng procedure whereby the prognosis of the operative procedure is materially improved and enhanced.

A still further object of my invention is to provide irnproved surgical apparatus which utilizes a rotary shearing action for resectng tissue and a cooperating rotary means for removing the resected tissue from the region of resection.

Another object of my invention is to .provide a novel and improved surgical apparatus which may be used to perform surgical transurethral prostatectomy operations.

These and other objects of my invention will become apparent from a consider-ation of the appended specification, claims and drawings, in Which- FIG. 1 is a side elevational view, partly cut-away, of one embodiment of my invention shown in operative position just prior to performing a surgical resectng procedure;

FIG. 2 is an enlarged sectional side elevational view of a second embodiment of my invention;

FIG. 3 is an end view of the right end of the apparatus shown in FIG. 2;

FIG. 4 is an enlarged section of a portion of FIG. 2 taken along section lines 4 4;

FIG. 5 is an enlarged sectional view of a portion of the left end of FIG. 2 taken 'along section lines 5-5 on FIG. 4;

FIG. 6 is an enlarged sectional view of the left end of FIG. 2 taken along section lines 6-6;

FIG. 7 is a side elevational view, partly in section, of a third embodiment of my invention;

FIG. S is a sectional view of the tissue resectng portion of my apparatus taken along section lines 8-3 on FIG. 7;

FIG. 9 is an end view of a portion of the apparatus shown in FIG. 1;

FIG. 10 is an enlarged side elevational partly sectional view of a further embodiment of my apparatus;

FIG. 11 is an enlarged side elevational view of a portion of my apparatus 'as utilized in the several embodiments shown in the drawings;

FIG. 12 is an enlarged side elevational, partly sectional view of one end of a further embodiment of my invention;

FIG. 13 is a view showing the relationship of the elements of FIG. 12 taken from the right end;

FIG. 14 is a view showing the relationship of the elements of FIG. l2 taken from the left end;

FIG. 15 is an illustration of a portion of my invention as utilized in the several embodiments; and

FIG. 16 is a right end view of the members shown in FIG. 15.

Referring to the drawing in which like elements are identified by like reference characters my invention is shown to be comprised of a support ensemble 10 and a surgical ensemble 11. The support ensemble 10 may conveniently be considered as the external end-portion 10 of my invention and is adapted to support various members of the surgical ensemble 11 which may be conveniently considered as the internal end-portion 11 of my surgical apparatus.

In FIG. 1, support ensemble 10 and surgical ensemble 11 are shown in preoperative disposition within the urethra 13. The surgical ensemble 11 includes three interconnected portions: an internal end-portion 15 disposed partly in the bladder 12, and partly in the sphincter of the urethra 13 between the bladder l2 and the prostate gland 14; an intermediate resectng portion 16 disposed in the prostate gland 14 and an external end-portion 17 disposed in t-he urethra proper 13 and in the external ensemble 10. Bladder 12, prostate gland 14 and urethra 13 are shown encompassed by surrounding tissue of the human body.

Referring first to FIGS. 2, 3, 4, 5 and 6` of the drawing, surgical ensemble 11 is shown comprised of an outer tube 30 which, for the sake of convenience in cleaning and assembling and disassembling, is conveniently comprised of hemispheric top and bottom sections 31 and 32 respectively. The tube 30 may also be considered as having short internal and long external end-portions 35 and 36 respectively, corresponding to the position of the apparatus when used in an operative procedure.

The resectng portion 16 of outer tube 30, near its internal end-portion 35, is provided with a plurality, preferably four, of generally helically parallel tissue feeding slots 34, which define a like plurality of tissue retaining and tissue shearing bars 33 for purposes to be explained below. The tissue retaining bars 33 serve to interconnect the internal and external end-portions 35 and 36 of top hemispheric sections 31 of the outer tube 30 and it may be apparent to one skilled in the art that the internal and external end-portions 35 and 36 respectively, of tube 30, are suitably divided into hemispheri-cal sections 31 and 32 to permit separating the combined tubes 30 and 40.

The tube 30 is comprised of a material which provides suitable resiliency, at least in the area encompassed by the slots 34 and tissue retaining bars 33 which are provided with an initial slightly outwardly bowed arcuate shape to promote further radial expansion of the retaining bars 33 by axial compression of outer tube 30. Top and lower hemispherical sections 31 and 32 may be provided with a suitable sleeve or surgical tape 37, if necessary, which may be utilized in the position shown in FIG. 2 to maintain sections 31 and 32 in operative cooperative cylindrioal relationship. In the event the collar 37 is used, narrow slots 41 and 42 are extended from 3 the ends of slots 34 into the short and long end-portions 35 and 36 of the tube 30 to permit said collar 37 to pass over the arcuate resecting portion 16.

An inner tube 40vis concentrically and rotat-ably journaled within t-he outer tube 30 and has internal short end-portions 45 and external long end-portion 46. On the longitudinally extending area adjacent to the tissue feeding slots 34 and tissue retaining and tissue shearing ybars 33 in outer tube 3i), said inner tube 40 is provided with one or more, preferably with a pair of opposite slots 43 which serve to dene a corresponding number of bladelike cutting bars 44 which are in s-hearing contact with the tissue retaining and shearing bars 33 of the outer tube 30, and which are provided with a slight initial radially outwardly extending arcuate conguration, and in like manner in the area of the outer tube 30, will upon axial compression of the tubes 30 and 40, expand radially.

As may be noted in FIG. 2, the outer surface of inner tube 40 and the inner surface of outer tube 30, are positioned contiguous to each other, and inner tube 40 is journaled within the outer tube 30, and the resilient shearing bars 44 cooperate with the tissue retaining and shearing bars 33 on outer tube 30, whereby tissue extending into slots 34 in outer tube 30, is sheared off in a resecting mode of operation upon rotation of the inner tube 40 in the outer tube 30.

The short and long end-portions 35 and 36 of the outer tube 30, and the short and long end-portions 45 Y land 46 of the inner tube 40, are shown to be one hundred and eighty degrees opposed, but other variations in degrees, for instance ninety degrees, may be possible. Providing this angularity in degrees, is one of the reasons the bars 33 and 44 being helical.

The direction of rotation of the inner tube 40 in outer tube 30 may be clockwise or anti-clockwise. However, as may become apparent from the description below, it may be desirable under certain operating conditions, to provide cutting bars 44 with a suitable configuration whereby cutting action to resect tissue will occur only in one direction of rotation, and upon a reversal of the trend of rotation, no cutting action will oc-cur. The exact nature of the configuration of cutting bars 44 and tissue retaining bars 33 for providing this function is not shown on the drawings and is believed to be within the capability of one skilled in the art upon becoming familiar with the principles of my invention. When the instrument is being inserted into the urethra, its worm conveyor may be gently rotated counter to the resecting rotation to prevent the shearing bars 44 from abrading the urethra.

The retaining and shearing bars 33 of the outer tube 30 and the shearing bars 44 of the inner tube 40 are substantially of the same angularity so that the radial expansion thereof be exactly the same. These shearing bars 33 and 44 are much preferably, dispo-sed at opposed angles to prevent the shearing edges of said bars 33 and 44 encountering each other. The tissue convolutions in the slots 34 also are sheared from end to end in opposed angularity of the shearing bars of one tube to those of the other t-ube.

`A means for conveying out the tissue as same `is resected, preferably in the form, as shown in FIG. 2, of a helical conveyor unit 51, extends through the entire length of the combined tubes 30 and 41) and partly out of the external and internal end-portions of said tubes 30 and 40. This worrn conveyor 51 is rotatably journaled in the lumen of the inner tube 40 in =a predetermined trend Of rotation and at a suitable velocity of rotation. It is constituted of three portions: an intermediate helical portion 51a,v a cylindrical external end-portion 110 and a cylindrical internal end-portion 53, said end-portions 110 and 53 being steadfastly affixed to the ends of the helical portion 51a. This -conveyor 51, as shown, in FIG. 2, is withdrawable from the internal end of the instrument.

The three portions 51a, 110 and 53 of the tissue conveyor 51, are of corresponding diameters, except where the ange means 61 encircles the end-portion 53 and are of a diameter corresponding to the diameter of the lumen of the inner tube 40. These three portions 51a, 110 and 53 of the conveyor 5l are axially provided with a means 56 adapted for the conveyance of uid, under pressure, through said fluid conveyor means 50.

This fluid conveyor means 50 may be in the form of an axial lumen or a diminutive tube 50 extending through said lumen, as illustrated, and may or may not be secured in the axially extending lumen 57 of the worm conveyor 51a.

The uid conveyor means 50 is in fluid communication with an elastic pneumatic member 71) on the internal end of the conveyor 51 in the bladder 12 and with a source of fluid supply (not shown). The ends of the tube 50 associate with the ends of the external and internal endportions and 53 in various possible permutations of which, illustrated embodiments will be subsequently described in the description of the cylindrical external and internal end-portions 110 and 53. In certain permutations at the ends of the lluid tube 50, it may be possible and desirable to pull out separately said tube 50 from the conveyor unit 51 for separately sterilizing the same.

FIG. 2 illustrates the internal end-portion ensemble 60 which comprises the internal endportion 53 constituted of two cylindrical end-portions 54 and 63 of different diameters, said end-portions 54 and 63 having an axial lumen to receive one end-portion of the tube 50. The end-portion 63 of greater girth, which is connected to the tissue conveyor 51a, is provided with a generally annular flange means 61 encircling the end thereof from which the smaller end-portion 54 axially extends into the bladder 12. This ange means 61 is very thin corresponding to the thickness of the internal ends 35 land 45 of the tubes 30 and 4t) combined. This flange means 61 alfords an abutment engaging the ends of the said internal endf portions 35 and 45 of the tubes 30 and 40 respectively.

A ferrule 62 encircles the internal hemispheric endportion 35 of the tube 30 to hold said hemispheric endportions 35 in contiguous relationship with end-portion 45 of the inner tube 40, and this ferrule 62 prefenably, may also encircle the rotary flange means 61 to prevent the rotation of said flange means 61 irritating the inner orifice of the urethra 13. This portion 63 is adapted to afford a journal for the concentric internal end-portions 35 and 45 of the tubes 30 and 40 respectively.

The end-portion 54 of the end-portion 53, is adapted to afford a support for a fluid holding elastic pneumatic member 70 mounted upon the swivel bushing 65' of suitable anti-frictional material as the plastic Teflon, in which, the end-portion 54 is journaled. The elastic pneumatic member 74) and the swivel bushing 65 do not rotate, when the portion 54 rotates, to prevent irritating tissue in the Abladder 12 and the orifice of the urethra 13. The inner and outer peripheries of this swivel bushing 65, las shown in FIG. 2, are parallel.

This free end-portion 54 has a screw-threaded axial bore in the free end thereof in axial communication with the lumen of the iluid conveying means 50. A nut means, preferably a wing-nut 67 may be provided with a pair of wings 66 on the outer side thereof and an axial boss on the inner side thereof, said -boss having external screwthread cooperating with the internal screw-thread of a bore in the end of the end-portion 54.

This nut means 67 has an axial lumen coextending with the lumen of the tube 50, but said axial lumen may be of a diameter to correspond to the diameter of the bore in the end of the portion 54, thereby permitting the tube 50 to be extended through the lumen of the said nut means 67, and thereby providing a grabbing endpiece for pulling the tube 5t) out of the conveyor 51. The object of this nut means 67 is to aiford Ia retainer for the swivel bushing 65 and the elastic pneumatic member 70. This nut means 67 is shown to be provided with a Washer 68 on the boss, but the wings 66 may be extended enough to eliminate the washer 68.

It will Ibe, noted that the diameter of the end-portion 54 with the swivel bushing 65 and the elastic pneumatic member 70 mounted thereon, preferably corresponds to the diameter of the end-portions of the tube 30.

When the end of the boss of the nut means 67 engages the end of the bore in the end-portion 54, there must be a slight clearance between the washer 68 and the ends of the swivel bushing 65 and the hub of elastic pneumatic member to permit free rotation of the endportion 54.

The elastic pneumatic member 70 mounted upon the end-portion S4 is, preferably, hemi-globular having an axial hub 71 projecting inwardly into said pneumatic member from the annular plane face thereof. The construction of the inner periphery of the hub 71 and the outer periphery of the swivel bushing 65 should be of a design to afford a rm engagement of each other. The plane face is the inner end of the hub 71 and the convex periphery of this member 76 is elastic mostly radially, to provide an extended annular abutment 70a to surround the urethral orice in the bladder 12. The hub 71 is sufficiently elastically flexile to pass over the wing-nut 6'7 in dismounting said elastic pneumatic member.

The ensemble includes a one-piece ferrule 80 and a segmental bushing 83. The ferrule 80 of the external peripherie support ensemble 10 is comprised of a hollow annular member having an axial lumen of a diameter yadapted to permit the removal of said ferrule 8@ from the 'surgical ensemble 11 over the resecting portion 16 thereof, preferably when said resecting portion 16 is radially retracted. The ferrule 80 consists of a central portion adapted to be manually held by the surgeon during surgery, an inner portion having an annual ange means 81 thereon and an outer portion having an annual-like flange means 83 thereon. This flange means 82 is substantially diametrically extended outwardly on opposite ends of the 4diameter thereof to provide a pair of support arms 38 and 39, one on each extension to carry a system of drivers 90.

In the lumen of the ferrule 80 between the inner periphery of the ferrule 8l) and the outer periphery of the tube 30, is disposed a bushing 83 which has yan end-portion 84 extending out of the inner end of the lumen to provide a hand-piece 84 for pulling the bushing 83 out of said lumen. This bushing 83 consists of at least two segments. This ferrule 8l), the bushing 83 and the outer tube 30, constitute a non-rotatable stationay unit. The inner tube 40 rotates in this unit and the conveyor means 51, rotates in the inner tube 40.

FIG. 2 illustrates the external end-portion ensemble 89 of the worm conveyor 51, which comprises the end-portion 110, lluid conveying means 50, connecting valve means '113, lock-means 133, pinion 112 and a wheel-nut 98.

The end portion 110 is provided with external screwthread of suitable pitch and it is of a diameter corresponding to the diameter of the lumen ofthe inner tube 4t) and will pass thru said lumen when conveyor 51 is being Withdrawn therefrom. This end portion 110 is of -a predetermined length adapted to carry the elements shown on it. It has an axial lumen provided, as shown, with the tube 50 for transmitting huid, under pressure, to the elastic pneumatic member 70. A screw-threaded endportion 52 is shown as protruding from the end-portion 110 and provided with a connecting valve means 113 adapted to be connected to a source of fluid supply. This valve means 113 may be connected to a bore in the end of the end-portion 110 and could be of a type as is used on vehicular tubes and could be connected to a fluid supply in various ways.

A system of drivers 90 shown as spur gears, are supported by the arms 38 and 39 of the flange means 82 of ferrule support 80 and by the end-portions 110 of the conveyor 51. This system of drivers 90 simultaneously drive the tissue resecting inner tube 40 and the conveyor 51 for the conveyance of resected tissue. Included in this system of drivers 90, are a master spur gear 96 and a pinion 112 which drive the two actuating elements of this surgical instrument, the inner resecting tube 40 and the conveyor 51. The spur gear 96 is non-rotatable affixed to the external end 46 of the resective tube 4t) and drives the same and it may be provided with an extended axial hub, 97 to provide an ample substance for axing non-rotatably said driver 96 to the end 46 of the inner tube 49. The driver 96 has -another function to afford abutment means engaging the ends of the 'reseoting tubes 30 and 411. The end of the inner tube 410 is extended and disposed in the hub ofthe driver 96 and secured therein, whereas, the end of the outer tube 3l) abuts the driver 96.

The pinion 112 is considerably wider than the rest of the spur drivers to provide meshing cogs of a width at least corresponding to the axial traverse of the pinion 112, which is secured to the conveyor 51 and is subject to longitudinal traverse therewith.

Iournaled in a journal-box 92 in the support arm 38 of the external ange means 82 is the end-portion of a journal 91. This journal is held in place therein by any suitable fastening means 93. A spur gear 94 is nonrotatably disposed on said journal 91, adjacent tothe outer face of flange means 82, and any suitable actuating means, shown as crank 9S, is affixed to the other end of said journal 91. It will be noted that the length of the support arm 38 of the ange means 82, much exceeds the length of the radius of the spur gear 96, to be adapted to carry the journal 91 and a pair of arms 102, over the periphery of the spur gear 96.

This spur gear 94 is in driving engagement with gear 96. A further journal 114 is non-'rotatably mounted in the bore 122 of the other opposite support arm 39, of the ange means 82 and is held in place by any suitable fastening means 121. A tubular spacer 116 is rotatably journaled on the journal 114 and includes a spur gear connected thereto at the inner end thereof in driving engagement with the gear 96. On the other end of the tubular spacer 116, is another spurigear 117 connected thereto. Gears 115 and 117 may not differ much in di- `ameters.

One end of the tie 118 is nonrotatably mounted upon the outer end of journal 114 and held in place by any suitable fastening means. A pivot has one end thereof mounted on the other end of the tie member 118. On the other end of the pivot 120 is mounted a trend reversing spur gear 119 disposed between pinion 112 and gear 117 and in driving engagement therewith. The pivot 120 may be rotatably journaled in either the tie member 118 or the spur gear 119 and held in place by any suitable fastening means. The function of the gear 119 is to reverse the trend of rotation of the pinion 112, which is the driving gear of the conveyor 51. The trends of rotation of the tube 30 and conveyor 51, thereby become opposed. A crossed belt would function in the same manner. The pinion 112 is, as shown, mounted screwthreadably on the end-portion 110 adjacent the wheelnut 98 and is non-rotatably secured thereon in this case by the lock-nut 133.

The compression means, a Wheel-nut 98, is screwthreadably mounted upon the end-portion 110` first, and then the pinion 112. This wheel-nut 98 is provided, on the periphery thereof, with anchor means, shown as, a pair of diametrically disposed indents 99, yand it is also provided, as shown, with a pair of studs 105 diametrically afxed thereto to afford stops between the said wheel-nut 98 and the driver 96, which also affords the external abutment means 96 engaging the external ends 36 and 46 of the tubes 30` and 4l).

This Wheel-nut 98 is arranged upon the end-portion 116 of the conveyor 51, so that an inner portion 106 of the screw-threaded end-portion 110, corresponding in length to the length of the traverse of the conveyor 51, is

reserved to be taken up as the resecting portion of the tubes 30 and 41E, is axially compressed and radially expanded. When the wheel-nut 98 is arranged on the endportion 11@ as described, the free ends of the studs 105 engage the .abutment-driver 96.

An interlocking device for interlocking with the wheelnut 93 is supported by the ange means 82. It is comprised of a pair of oppositely disposed support arms 162 extending laterally from the flange means 32, over the periphery of the driver 96, each having, as shown, a bifurcated end 1&3 provided with a pivot 1111. Each of said arms 102 is pivotally provided with an anchor member, shown as a bar 160 having the free end thereof adapted to interlock with the indents 99 of the wheel-nut 98. These support arms 102 are shown as being integral with the flange means 52, but they could be attached by screw means `such as screws 104 shown in FIG. 7. When the interlocking device is interlocked with the wheel-nut 9S, said wheel-nut is rendered non-rotatable. And when the `inner tube 40 and the conveyor 51 are rotated by the system of drivers 90, end-portion 116 screw-threadably traverses the wheel-nut 98.

This nut-wheel 98 actually performs two functions: exerting a pushing stress7 thru the studs 105, against the external ends of the tubes 3i) and 4@ via the abutting means 96; exerting an opposed pulling stress upon the conveyor 51 and its ange means 61, by the cooperation of the screw-threads of the said wheel-nut 98 and of the end-portion 110, against the internal ends of the tubes 3f) and 40. By these two opposed tensional stresses of pushing and pulling, the resecting portion of the tubes 30 and 40, is axially compressed and radially expanded.

In the embodiment of FIG. 1, is illustrated the external cylindrical end-portion 127 provided with continuous external screw-thread 12S, and yconnecting valve means 113 at the free end thereof; said end-portion 127 is further provided with a pinion 129 for driving the conveyor 51 Iand with a suitable means, shown as a lock-nut 133, for locking non-rotatably on the end-portion 27, said pinion 129.

Inwardly of the pinion 129, on said end-portion 127, is screw-threadably mounted an operatively independent hand-wheel-nut 125 having serrate means 126 in the periphery thereof for manually actuating said wheel-nut 125, and finally an arcuate flat spring member 123 having an axial bore 124 is mounted on the end-portion 127, said spring 123 having a pair of diametrically extended spring :arms tensionally engaging the abutment-drive 96 while the bared portion thereof tensionally engages the handwheel-nut 125. Like elements have been identified with like reference characters as the various elements utilized may be identical.

As may be seen on the free end of FIG. 1, the driving means `for driving the end-portion 127 of conveyor 51, is substantially that shown in FIG. 2 and that described above. The mechanically Operated means 98, shown in FIG. 2, for axially compressing and radially expanding the resecting portion 16 of the surgical ensemble 11, is substituted by a manually operable means, a hand-wheelnut 125, and by a spring means 123 in leaf form, since a coil spring would obstruct the extrusion of the resected tissue from the worm portion 51a of the conveyor 51. The hand-wheel-nut 125 is actuated intermittently as the surgery progresses.

The spring means 123, wheel-nut 125 and pinion 129 are mounted on portion 127 in the sequence recited.

In FIG. 7, a modification of ferrule 80 and driving means 90 is illustrated as applied to surgical ensemble 11. Ferrulev 80 is shown comprised of two hemi-sections 85 `and S6, and having an -annular flange S1 on the inner end thereof and a flange means 82 on the outer end thereof. The inner flange 81 has a screw-threaded periphery provided with an internally screw-threaded ring 87. The outer flange means 82 consists of an outer ange means diametrically extended from the axis thereof to provide support arms 3S and 39 for support arms 102. And the outer fiange means 82 consists of an inner axially annular externally screw-threaded boss provided with an internally screw-threaded ring 88. The diameter of this boss, preferably, exceeds the Idiameter of the inner flange 81, not including the ring 87, to permit removal of the ring S3 from the ferrule 80. This ferrule 80 has an axial lumen (not shown) which is suitably dimensioned frictionally to engage the outer surface of outer tube 30` when ferrule S@ is in the assembled position shown in FIG. 7.

In FIG. 7, the internal end-portion 60 corresponding to. portion 63 of end-portion 53 in FIG. 2, is provided with a thin ring 61 adapted to afford an abutment bearing against the inner ends of tubes 3) and 40, to substitute the flange means 61 in FIG. 2. This ring 61 is shown to be provided with internal thread 72 adapted to mesh with external thread 73 on the cylindrical portion 60. The portion 63 is provided with an axial lumen 74 slideably to receive the tube 5i? for conveying fluid, and is adapted to afford a journal for the internal end-portion 35 of tube 30. The remainder of the internal end-portion 60 of surgical ensemble 11, may be same as shown in FIGS. 2,.4, 5, and 6. In the embodiment of FIG. 7, by removing the ring 61, the conveyor 51 can be pulled out from the external end of the tube 311.

Driving system 91D has been modified by providing a pulley 1311, which is non-rotatably affixed to the outer end of the tubular spacer member 116. This pulley has a anged or arcuately dished periphery to retain thereon the belt 131 while the drum 132 is in axial traverse.

Drum 132 and a lock means 133, both of which are internally threaded, lare adapted -to be threadably received and positioned on the outer end of end-portion 127 and locked thereon by frictional engagement between the adjacent surfaces of drum 132 `and lock-nut 133.

A suitable driving belt 131 extends around the periphery of drum 132 and pulley 130, thereby to transmit driving energy to drum 132 of the conveyor 51. Belt 131 may be crossed, thereby deleting the trend reversing gear 119. The remainder of the elements comprising driving means 9i) have been identified by like reference characters as shown on FIG. 2 of the drawing.

On FIG. 7, the internal end-portion 6) corresponding to portion 63 of end-portion 53 in FIG. 2, is, as shown, provided with a thin ri-ng 61 adapted to afford an abutment bearing against the inner ends of tubes 30 and 40, to substitute the flange means 61 in FIG. 2. This ring 61 is shown to be provided with internal thread 72 adapted to mesh with external thread 73 on the cylindrical portion 63. The portion 62 is provided with an axial lumen 74 slideably to receive the tube 50 for `conveying fluid, and is adapted to afford a journal for the internal endportion 35 of tube 30. The entire conveyor 51 has the aspect of affording a journal for the tube 36 of the surgical ensemble 11. The remainder of the internal end-portion 60 of surgical ensemble 11, may be same as shown in FIGS. 2, 4, 5, and 6. In the embodiment of FIG. 7, by removing the ring 61, the conveyor can be pulled out from the external end of the tube 3f).

FIG. l0, a further embodiment of the internal endportion 60 of surgical ensemble 11, illustrates the cylindrical larger portion 144 having a threaded axial bore in the inner end thereof.

A smaller cylindrical portion 146 is provided with external threads 142 in the outer end thereof screwthreadably cooperating with the said threaded bore of the larger portion 144.

In the inner end, said smaller portion 146 is provided with a threaded axial bore and said axial bore is provided with, so to speak, a wing-nut 143 having a screwthreaded boss 55 adapted, threadably, to cooperate with said inner threaded bore. The wing-nut 143 has a lumen adapted to receive the end of the tube 50. The smaller portion 146 is provided with an annular fiange 145 adapted 9 to afford an abutment bearing against the ends of the tubes 30 and 4t). The larger portion 144 and the smaller portion 146 have a continuous lumen adapted to receive the tube 50. The ferrule 62 extends over the periphery of the outer tube 30 a-nd over the annular flange 145. Said ferrule 62, preferably, has the ends thereof beveled.

The hub 140 of the elastic pneumatic member 70, and the swivel sleeve 141 on the smaller portion 146, have been modified. The swivel Sleeve 141 and the portion 146 have horizontal rotatably cooperative peripheries, Whereas the outer periphery of the swivel sleeve 141 and the inner periphery of the hub 140 of the elastic pneumatic member 70 are tapered opposedly, the swivel sleeve 141 tapering concentrically to the outer end thereof, thereby anchoring the hub 140 on said swivel sleeve 141 and the retainer nut 143 retains the swivel sleeve 141 only, and the hub 140 can be manually pulled off the said swivel sleeve 141. The seal of the above elements is fluid tight. The elastic pneumatic member 70, when inflated by fluid under pressure becomes elastically expanded as shown at 70a. The object of this ensemble as modified, is to permit the removal of the conveyor 51 from the internal end of the surgical ensemble, when the flanged portion 146 is detached.

An enlarged representation of the external portion of tube 50, conveyor 51 and threaded end-portion 127 is shown in FIG. 1l.

FIGS. 12, 13 and 14 illustrate a still further embodiment of my invention in which ferrule 80 as illustrated on FIG. 7 and in the system of drivers for axially compressing and radially expanding the resecting portion as shown on FIG. 2, are shown in detail. The arms 102 are shown as being integral with the flange means S2 of Support 80, and the conveyor 51 is shown with the tube 50 and provided With a channel course extending thru the axial body of the worm of the conveyor 51.

FIGS. 15 and 16 illustrate one embodiment of the form that member 31 and 32 may take which shows the resecting portion 16 displaced one hundred and eighty degrees. In FIG. 15 a side elevational view of member 31 is shown as having hemi-sectional internal and external ends 35 and 36 respectively and having a pair of tissue retaining and shearing bars 33 extending therebetween. Complementary member 32 is constructed in a complementary manner. The assembled hemi-sectional portions will cooperate to provide internal and external tubular short and long end-portions respectively with a plurality of tissue resecting bars 33 connected to the said endportions.

Uperaton Referring to FIG. 1 of the drawing, my apparatus is first prepared for insertion into the urethral Icanal by manipulating the adjusting means 125 so that the Iresecting portion 16 of surgical ensemble 11 is at its smallest radial dimension in which, tissue resecting bars 33 and 34 assume a slightly outwardly convexly arcuate config uration, which need not be much greater in diameter than the diameter of sleeve 62 or sleeve 37, whereby the dead center of straight bars is eliminated. This slight initial pre-expansion of the resecting portion 16, determines the maximum diameter of the surgical ensemble 11 to be inserted into the urethral canal. The instrument is antibiotically salved, particularly in the resecting portion. As the instrument is being introduced, the inner tube 40 may be slowly rotated in the direction counter to the resecting direction, whereby no damage by abrading, is done to the canal other than the prostatic canal. The instrument is inserted suliiciently deep, so that the internal end-portion thereof 60, that is, the end-portion on which the elastic pneumatic member 70 is mounted, is disposed in the bladder 12. Suitable -uid, under pressure, is then introduced thru the connecting valve means 113 and thru the fluid conveying means 50, into the elastic pneumatic member 70 to be expanded to the configuration indicated by reference character 70a. The instrument is then manually tensioned, by slight pull thereon, against the wall surrounding the urethral orifice in the bladder 12, whereby the resecting portion 16 is positioned accurately in the pros-tate gland for resection. During the surgery, the prostatic tissue is fed into the resecting portion 16 and this is accomplished by axially compressing and radially expanding the resecting portion, whereby the tissue is subjected to tensional stress forcing the tissue into the tissue feeding slots 34 and 43 of the resecting portion 16 of the surgical ensemble 11. Rotating the inner tuhe 40 of the surgical ensemble 11, by crank 95, will cause the shearing bars of the resecting portion 16 'to shear olf the tissue convolutions ycrowding into said resecting portion 16. It may be noted that actuating the crank 95, will rotate gear member 96 at a predetermined speed determined by the gear ratio between gears 94 and 96.

Simultaneously, tissue conveyor 51 is rotated thru gear 115 in mesh with gear 96, and gears 117 and 119 in mesh with pinion gear 129 nonrotatably mounted on endportion 127. The -trends of rotation of resecting tube 40 and of resected tissue conveyor 51 is in the same direction, if trend reversing gear 119 is not used, or if a belt 131 is not crossed. Otherwise, the trends are reversed.

If the trends of rotation of the tube 4) and of the conveyor 51, are the same, the speeds thereof must differ. If the trends of Irotation of the tube 4&1 and conveyor 51, are opposed, the speeds thereof are immaterial, however, the speed of the conveyor 51 must be ample to extrude all the tissue as same is resected. The conveyor 51, extrudes the resected tissue from the external end thereof.

Gradual axial compression of the resecting portion 16 causes gradual radial expansion of said resecting portion 16. This compression and expansion function of the resecting portion 16 is produced by the application, against the ends of the surgical ensemble 11, of opposed tensional stresses. These opposed tensional stresses are produced mainly by three cooper-ating elements: a nut 98 designated in FIG. 2 as a hand-wheel-nut screw-threadably cooperating with the screw-threaded end-portion 110 of conveyor 51; and anchor means to restrain or anchor the nut 98, which is in one form in FIG. 1 and in another form in FIG. 2. The nut 98 is anchored to be nourotatable on the rotatable end-portion 110 of conveyor 51, lwhereby the rotation of end-portion 110, counter clockwise in the nut 98, causes the end-portion 110 to traverse thru the nut 98 outwardly. The hand-wheel-nut in FIG. l, is manually and independently rotatable to exert a pushing stress upon the outer ends of tubes 30 and 40 via the spring 123 and a pulling stress upon the conveyor 51. The wheel-nut in FIG. 2, is not rotated either mechanically or manually, but the screw-threaded endportion 110 is screw-threadably rotated thru said wheelnut, to exert a pushing stress upon the outer ends of tubes 30 and 40 via studs 105, and a pulling stress upon the conveyor 51.

The embodiment of FIGS. 2 and 7 provide mechanically automatic actuative cooperation of the externally screw-threaded end-portion 110 or 127, and the internally screw-threaded nut 98 axially to compress the resecting portion 16 and simultaneously radially to expand said resecting portion 16. Rotating the crank 95 in the proper direction actuates the system of drivers 90, whereby the pinion 112 and drum 132 a-re rotated to cooperate screwthreadably with the wheel-nut 98 to produce opposed tensional stresses upon the ends of the surgical ensemble 11.

It is anticipated that those skilled in the ar-t, upon becoming aware of the principles of my invention will, by suitable experimentation, be able to determine ratios for driving the inner tube 40 at desirable diiferent directions and velocities. It will likewise 'become apparent to those skilled in the art, that the pitch of the external threads on end-portion will be determined by the desired rate of expansion of the resecting-portion 16 of the surgical ensemble 11.

11 In the embodiment of FIG. 2, the instrument may easily be disassembled by withdrawing the segments of .bushing 83 toward the left, removing fastener 67 with its Washer 68 from the internal end of end-portion 54, FIG. 5, sliding ferrule 62 off the internal end of surgical ensemble 11, disengaging anti-rotation arms 100 from wheel-nut 98, withdrawing hemispheric sections 31 and 32 of tube 3@ from tube 40, withdrawing tube 50 toward the right, removing Wheel-nut 98, pinion 112 and lock-nut 133 from conveyor 51 and iinally withdrawing conveyor 51 out of tube 4t).

In the embodiment of FIGS. 7, 12, 13, and 14, ferrule 80 may be disassembled by removing lock-rings 87 and 88 and separating the hemi-sections 85 and 86 from the surgical and driving ensembles 11 and 90 respectively. Removal of lock-nut 133, pinion 112 or drum 132 and wheel-nut 98 and removal of the internal end-portion eti and the elastic pneumatic member 70 will allow easy disassembly for cleaning and sterilizing after the surgery has been completed.

It may now be apparent that conveying means 51 and tube 50 may be formed independently of each other and the tube 50 simply rides along with the conveyor 50 rotating idly therewith. The trend of rotation of the conveyor 51 is determined by the trend reversing drivers, gear 119 and belt 131, with respect to the trend of rotation of the tube 40, so that resected tissue will be extruded from the conveyor 51 during surgery.

It may further be apparent that tbe embodiment shown in FIGS. 2, 7, and 12 are reversible in operation and that rotation of the driving means 95 `and 89 respectively will serve to expand or retrace the surgical resecting portion 16 of my invention. The edges of the tissue retaining bars 33 and cutting bars 44 may be suitably adapted to provide a shearing action upon relative rotation in only one direction so that relative rotation in a reverse direction will not effect a shearing action of any tissue that mlay be present in the slots 34. To promote a circumferentially universal feeding of the prostatic tissue into the feeding slots 34, the instrument may be slowly rotated in the urethra as the -resecting progresses.

It is believed that those skilled in the art, upon becoming familiar with the principles of my invention, may easily determine suitable materials for the construction of the various elements of the instrument.

It is to be understood that suitable modification may be rnade in the structure as disclosed, provided such modifications come within the spirit and scope of the appended claims. Having new fully illustrated and described my invention, what I claim to 4be new and desire to protect by Letters Patent, is:

1. In a surgical resecting apparatus of the character described, the combination comprising:

, (a) a iirst longitudinally-wise elongated tubular mem.-

ber, said tubular member having internal and ex-` ternal end-portions, and an intermediate radially expandable slotted portion;

(b) a second longitudially-wise elongated tubular member concentrically rotatable within said rst tubular member, said second tubular member Ahaving internal and external end-portions, and an intermediate radially expandable slotted portion in axial registration with the intermediate slotted portion of said tubular member;

(c) conveyor means, rotatable in said second tubular member for conveying resected tissues out of said second tubular member, said conveyor means simultaneously affording means for transmitting tensional stress to the internal end-portions lof the first and second tubular members, said conveyor means having internal and external end-portions;

(d) tension means screw-threadably cooperating with the external end-portion Iof the conveyor means for providing tensional stress and simultaneously transmitting said stress to the external end-portion of said conveyor means and. to the external end-p0rtions of the lirst and second tubular members, axially to compress the slotted portions of said first and second tubular members, whereby said slotted portions of said iirst and seco-nd tubular members are nadially expanded;

(e) external support means adapted to be engaged by the hand of an operator, non-rotatably mounting said first tubular member; and

(f) driving means connected to the external end-portion of the second tubular member to rotate said second tubular member, and thereby resect tissue extending into the slotted intermediate portions of said first and second tubular members, said driving :means being connected to the exte-mal end-portion of the conveyor means to rotate said conveyor means, thereby conveying resected tissue out of said second tubular member.

2. The apparatus of claim 1 in which at `least one of the tubular members is comprised of a pair of hemisectional portions.

3. The apparatus of claim 2 in which the internal and external end-portions are radially opposed in specific number of degrees.

4. The apparatus in claim 1 in which the means extending intermediate the ends of the internal and external end-portions of the rst land second tubular members, is a conveyor means rotatable Within the second tubular member, and connected to the driving means.

5. The apparatus of claim 4 in which the external end,- portion of the conveyor means and the external end-portion of the second tubmular member, are threadably cooperating with the external support `and with the system of drivers, including a tension providing member, said tension providing member simultaneously transmitting tensional stresses to the external end-portion of the conveyor means and to the internal end-portions of said tubular members, thereby axially compressing and simultaneously radially expanding the slotted portion of said first and second tubular members, said conveyor means laxially relaying the tensional stress to the internal endportions of the irst and second tubular members, thereby providing opposed tensional stresses at the ends of said tubular members.

6. The apparatus of claim 4 in which an elastic pneumatic member is disposed on the internal end-portion of said conveyor means, said conveyor means having a conduit extending therein from end to end thereof and in fluid communication with said elastic pneumatic member, said conduit being `adapted to convey fluid, under pressure, to said elastic pneumatic member land being provided at the external end thereof with a valve means for connecting said iiuid conduit to a source of uid supply.

7. The apparatus of claim 1 in which the slotted portions in said rst and second tubular members are disposed lat Ian angle to the longitudinal axes thereof.

8. The apparatus of claim 7 in which the slotted portion in said tirst tubular member and the slotted portion in said second tubular member are disposed at different angles tol the longitudinal axes tihereof.

9. A surgical resecting instrument comprising in combination: an external tubular support having an axially extending channel formed therein and being adapted to be engaged by the hand of an operator; a iirst tubular member having an external end concentrically stationarily disposed in said support, an internal end, and a plurality of longitudinally-wise elongated slots positioned around the periphery thereof, said slots being disposed a predetermined distance from said internal end, and said first tubular member being laterally expansible in the area encompassed by said slots; a second rotatable tubular member concentrically disposed within said 'lirst tubular member and having internal and external ends and a plurality of longitudinally-wise extending cutting bars, said second tubular member being laterally expansible in the area encompassed by said cutting bars; rotatable conveying means mounted concentrically inside of said second tubular member, said rotatable conveying means including a channel extending axially therein and having internal and external ends; flange-abutment means at the internal end of the conveying means for engaging the internal ends of said tubular members; drive-abutment means at the external ends of the tubular members for engaging the external ends of said tubular members; tension means intermediate the external ends of said first and second tubular members and the external end of said conveying means for providing variable axially opposed tensional stresses operative on the internal and external ends of said first and second tubular members, an elastic pneumatic member disposed on the internal end of said conveying means in fluid communication with the internal end of the axially extending channel in said conveying means; driving means operatively connected to said second tubular member and said conveying means, said driving means actuating the second tubular member and the conveying means at predetermined velocities and predetermined directions; and valve means for connecting the external end of the axially extending channel in said conveying means to a source of fluid supply.

10. The apparatus of claim 9 in which the slots in the first tubular member are angularly disposed and in which the cutting bars in the second tubular member are angularly disposed, said angularity of the cutting bars being opposed to the angularity of the slots.

11. A surgical resecting instrument of the character described, comprising in combination: an external tubular support adapted to be engaged by the hand of an operator; a pair of concentric tubular members disposed in said tubular support and having internal and external ends, said tubular members having a tissue resecting portion intermediate the ends thereof, including alternating elongated tissue feeding slots and elongated tissue shearing bars formed in the periphery of each tubular member of said resecting portion, said resecting portion being axially arranged in said pair of tubular members to be disposed in the prostate gland and adapted to be expanded therein, said pair of tubular members being provided with an abutment means adapted tensionally to engage the external ends of said pair of tubular members; a rotatable conveyance means extending through the inner tubular member and having internal and external end-portions extending from the internal :and external ends of said pair of tubular members, the internal end-portion being provided with an abutment means adapted tensionally to engage the internal ends of said pair of tubular members, and said external end-portion being provided with external screw-thread, said rotatable conveyance means -being adapted to c onvey resected tissue out of the inner tubular member, and being adapted, simultaneously, K

to transmit tensional` stress to the internal ends of the pair -of tubular members, via the abutment means engaging the internalends of said pair of tubular members, said conveyance means having an axial channel adapted to convey fluid, under pressure, extending therein from end to end; elastic pneumatic means adapted to receive fluid, under pressure, hermatically disposed upon the internal end-portion of the conveyance means and in fluid communication with the axial channel in the end of the internal end-portion of the conveyance means; connecting valve means connected to the end of the external end-portion of the conveyance means and to Va source of fluid supply and being in fluid -communication with the uid channel of said conveyance means; tension means screwthreadably cooperating with the external end-portion of the conveyance means, adapted to provide opposed tensional stresses and adapted to transmit said tensional stresses to the respective internal and external ends `of the pair of tubular members, axially to compress the resecting portion of the tubular members, thereby expanding said resecting portion, said opposed tensional stresses 14 being transmitted to the internal ends of the pair of tubular members via the conveyance means, and via the abutment means of the internal end-portion of the conveyance means, and said opposed tensional stresses being transmitted to the external ends `of the pair of tubular members via the abutment means of the external ends of the pair of tubular members; a system of cooperative drivers, associated with the external support, with the inner tubular member and with the conveyance means, and driving said inner tubular member and said conveyance means.

12. In an instrument of the character described, a hollow support; a pair of concentric tubes disposed in said hollow support, the outer tube being stationary and the inner tube being rotatable in said outer-tube, the outer tube being in two heini-sections for disassembling the same from the inner tube, each of said tubes having an intermediate radially fiexible slotted resecting portion, each of said resecting portions including a plurality of tissue shearing bars defined by and disposed betweentissue feeding slots formed in the periphery of the tube wall of each resecting portion; resected tissue conveyor rotatably disposed in the inner tube; driving means carried by the support, by the inner tube and by the conveyor and driving said inner resecting tube and said coveyor.

13. Surgical resecting apparatus of the character described comprising an elongate tube having an opening formed in the wall thereof for feeding tissue into said tube, said tube including internal and external end portions, and including an elastic pneumatic member connected with the internal end portion of said tube,

a conduit mounted in said tube adapted to convey fluid to said pneumatic member,

and cutting means mounted in said tube and movable relative thereto and adapted to resect tissue fed into said tube through said opening.

14. The apparatus of claim 13, including conveyor means mounted in said tube and movable relative thereto for conveying resected tissue longitudinally out of said tube.

I15. Surgical resecting apparatus of the character described comprising p (a) an elongate tube having a radially expandable apertured portion formed in the wall thereof for feeding tissue into said tube, and

(b) cutting means mounted in said tube and movable relative thereto, said cutting means being radially expandable relative to said tube and adapted to resect tissue fed into said tube through the apertured portion thereof.

16. Surgical resecting apparatus of the character de- 5scribedcornprising (a) a rst elongate tube being of a ysize for insertion into the urethral canal of a human patient, said first tube having an lapertured portion formed in the wall thereof for feeding tissue into said tube, (b) a second elongate tube concentrically and rotatably mounted in said first tube, said second tube having an apertured portion formed in its wall generally opposite to the apertured portion of said first tube `and adapted to resect issue fed into said first tube through the apertured portion thereof when said second tube is rotated, and (c) the apertured portions of both said tubes being radially expandable.

17. Surgical resecting apparatus of the character described comprising (a) a tirst elongate tube being of a size for insertion into the urethral canal of a human patient, said first tube having an apertured portion formed in the wall thereof for feeding tissue into said tube, (b) a second elongate tube concentrically and rotatably mounted in said first tube, said second tube having an apertured portion formed in its wall generally opposite to the apertured portion of said first tube and adapted to resect tissue fed into said first tube through the apertured portion thereof when said second tube is rotated, and (c) both of said tubes being axially compressible and the apertured portions thereof being adapted to radially expand in response to the axial compression thereof, and means for axially compressing both of said tubes simultaneously.

18. Surgical resecting apparatus of the character described comprising (a) a first elongate tube being of a size for insertion into the urethral canal of a human patient, said first tube having an apertured portion formed in the Wall thereof for feeding tissue -into said tube, (b) a second elongate tube concentrically and rotatably mounted in said first tube, said second tube having an apertured portion formed in its wall generally opposite to the apertured portion of `said first tube and `adapted to resect tissue fed into said first tube through the apertured portion thereof when said second tube is rotated, (c) a conveyor rotatably mounted in said second tube -for conveying resected tissue longitudinally out fof said second tube, and (d) means for rotating said second tube and said conveyor simultaneously.

19. Surgical resecting apparatus of the character described comprising (a) a irst elongate tube being of 4a size `for insertion into the urethral canal of a human patient, said first tube having an apertured portion formed in the wall thereof for feeding tissue into said tube, (b) a second elongate tube concentrically and rotatably mounted in said first tube, said second tube having an apertured portion formed in its wall generally opposite to the apertured portion of said first tube and adapted to resect tissue fed into said first tube through the `apertured portion thereof when said second tube is rotated, and (c) said tubes have internal and external end portions, and including an elastic pneumatic member connected lto said tubes and disposed adjacent to and outwardly of the internal end portions-of said tubes, and a conduit mounted in `said second tube adapted to convey fluid to said pneumatic member.

20. The apparatus of claim 19, including a conveyor rotatably mounted `in said second tube for conveying resected tissue longitudinally out of said second tube, said conveyor including an elongate rotatable tubular shaft extending longitudinally of said second tube and having means mounted thereon for the laforementioned conveyance of said tissue, said shaft serving as said conduit for conveying fluid to said pneumatic member.

21. Surgical resecting apparatus of the character described comprising (a) -a iirst elongate tube being of a size kfor insertion into the urethral canal of a human patient, said first tube having an apertured portion formed in the wall thereof for feeding tissue into said tube, (b) a `second elongate tube concentrically and rotatably mounted in said first tube, said second tube having an apertured portion formed in its wall generally opposite to the apertured portion of said first tube and adapted to resect tissue fed into said iirst tube through the apertured portion thereof when said second tube is rotated, and (c) said tubes have internal and external end portions, and including an elastic pneumatic member connected to said tubes and disposed adjacent to and `outwardly of the internal end portions of said tubes, and a conduit mounted l@ in said second tube adapted to convey iiuid to said pneumatic member, and further including a conveyor rotatably mounted in said second tube for conveying resected tissue longitudinally out of said second tube.

22. Surgical resecting apparatus of the character described comprising Y (a) a first elongate axially compressible tube having internal and external end portions and an apertured portion formed in the Wall thereof for feeding tissue into said tube,

(b) a second elongate axially compressible tube concentrically mounted in said first tube and rotatable relative thereto, said second tube having internal and external end portions and an apertured portion formed in its wall generally opposite to the apertured portion of said first tube and adapted to resect tissue fed into said first tube through the apertured portion thereof when said second tube is rotated,

(c) the apertured portions lof each tube being radially expandable in response to axial compression of its respective tube,

(d) means for axially compressing both of said tubes,

(e) a conveyor rotatably mounted in said second tube for conveying resected tissue longitudinally out of said second tube,

(f) an elastic pneumatic member connected with said tubes and disposed adjacent the internal end portions thereof,

(g) a conduit mounted in said second tube in communication with said pneumatic member for conveying fluid thereto to expand said pneumatic member, and

(h) means for rotating said second tube and said conveyor.

23. The apparatus of claim 22, wherein the apertured portion of each of said tubes comprises a plurality of helically oriented elongate slots defining therebetween helically oriented tissue shearing bars, the slots and bars of one tube being angularly offset from the slots and bars of the other tube, the means for rotating said second tube and conveyor is adapted to rotate them simultaneously, the means for axially compressing said tubes is adapted to compress them simultaneously, and wherein said conveyor includes a tubular rotatable shaft which serves as the conduit for conveying liuid to said pneumatic member.

References Cited by the Examiner UNITED STATES PATENTS 1,416,067 5/1922 Royle 146-185 X 1,483,742 2/1924 Nicol 259--105 1,663,761 3/1928 Johnson 12S-305 2,317,177 4/1943 Carissimi 30-34.2 2,701,559 2/1955 Cooper 128-344 FOREIGN PATENTS 39,666 4/ 1907 Switzerland.

RICHARD A. GAUDET, Primary Examiner.

G. MCNEILL, Assistant Examiner, 

13. SURGICAL RESECTING APPARATUS OF THE CHARACTER DESCRIBED COMPRISING AN ELONGATE TUBE HAVING AN OPENING FORMED IN THE WALL THEREOF FOR FEEDING TISSUE INTO SAID TUBE, SAID TUBE INCLUDING INTERNAL AND EXTERNAL END PORTIONS, AND INCLUDING AN ELASTIC PNEUMATIC MEMBER CONNECTED WITH THE INTERNAL END PORTION OF SAID TUBE, A CONDUIT MOUNTED IN SAID TUBE ADAPTED TO CONVEY FLUID TO SAID PNEUMATIC MEMBER, AND CUTTING MEANS MOUNTED IN SAID TUBE AND MOVABLE RELATIVE THERETO AND ADAPTED TO RESECT TISSUE FED INTO SAID TUBE THROUGH SAID OPENING. 